十二指肠乳头癌根治术后复发再切除1例报导

本文报告一例高分化十二指肠乳头癌局部切除后６年复发，有胰头肿块、胰周淋巴结转移，肠系膜上动静脉血管侵犯，予以再切除，随访１６个月，病人恢复原工作。现针对此类腺癌复发处理的态度及再切除的可能性，予以讨论。

RESECTION OF RECURRENT HIGH DIFFERENTIATEDPAPILLOCARCI NOMA OF DUODENUMSURGI CAL TECHNIQUEAND CASE REPORT

case of recurrent high-differentiated papillocarcinoma of duodenum 6years after the primary operation was re-operated on by extensive resection.There were recurrent tumor tissues spreading over the total pancreatic head,juxtapancreatic region and regional lymph nodes which infiltrated into the superi-ormesenteric vessels and portal vein.These vessels were segmentally resectedwith the tumor tissue and the circulation was reconstructed by end-to-end anas-tomosis of the SMA and mesenteric-caval shunt. The patient resumed her origi-nal work and enjoys a life of good quality at follow-up 16 months postoperativ-ely. The authors reported the surgical techniques in detail and thinks that reop-eration by an extensive resection is technically feasible and practically valuablesince the malignancy is of low grade.Further more , this technique can be applied to the resection of advanced pri-mary carcinomas of the peri-ampullary region.